Surgery for Abdominal Aortic Aneurysm
During surgery for abdominal aortic aneurysm (AAA), the weakened aortic wall is replaced with a hollow manmade tube (a graft).
During open surgery, a graft replaces the weakened section of aortic wall. The wall is wrapped around the graft.
During an endovascular procedure, a graft is inserted inside the aortic wall. The graft is then secured to the aorta above and below the aneurysm.
Reaching the aneurysm
The aorta can be reached through open surgery. Or a less invasive endovascular procedure may be done. Your surgeon will choose the best approach for you.
An incision is made in your abdomen. Once inside, your surgeon gently moves aside your organs to reach the damaged section of the aorta.
Near your groin, 2 small incisions are made. Then a catheter (a thin, flexible tube) is threaded into the artery at the incision. A graft is placed inside the catheter and guided toward the damaged part of the aorta.
Placing the graft
The goal is to safely route blood past the aneurysm.
During open surgery
Here is what to expect:
The aneurysm is opened and cleaned of any blood clot.
The graft is sewn to the aorta.
The wall of the aorta is wrapped around the graft to protect it. The wall is then sewn up.
The incision site is closed with sutures or staples.
During an endovascular procedure
Here is what to expect:
Watching the catheter on a video monitor, the surgeon places a catheter in the best position. This position is confirmed by an angiogram (dye study).
The graft is guided through the catheter and expanded so blood can flow through it.
The blood is now re-routed through the graft and does not fill the aneurysm anymore.
The graft is attached inside the artery. It is held in place with stents (metal springs), hooks, or pins.
The catheter is removed. The incision sites are closed with sutures or staples.
Risks and complications
Here are potential problems to be aware of:
Blood clots in legs
Injury to the colon’s blood supply
Spinal cord injury
Heart attack, stroke, or death
July 25, 2018
Surgical and endovascular repair of ruptured abdominal aortic aneurysm. UpToDate, Walker, TG. Clinical Practice Guidelines for Endovascular Abdominal Aortic Aneurysm Aortic Aneurysm Repair. Journal of Vascular Interventional Radiology (2010); 21(11); pp2-s1655. s163
Images reviewed by StayWell medical illustration team.,Kolbus, Karin, RN, DNP, COHN-S,Mancini, Mary, MD